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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155801264
Report Date: 05/02/2022
Date Signed: 05/02/2022 01:11:28 PM


Document Has Been Signed on 05/02/2022 01:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:HALLMARK OF BAKERSFIELDFACILITY NUMBER:
155801264
ADMINISTRATOR:MATTHEWS, SAVANNAHFACILITY TYPE:
740
ADDRESS:2001 AKERS ROADTELEPHONE:
(661) 834-0200
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:70CENSUS: 45DATE:
05/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Assistant Administrator Ashley Candelas.TIME COMPLETED:
01:30 PM
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On 05/02/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced at the above facility to conduct an Annual Inspection- Infection Control. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. LPA met with Assistant Administrator Ashley Candelas.

LPA conducted a tour with Assistant Administrator Ashley Candelas. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point. Facility appeared cleaned with no obstruction or fire clearance issues. Hand sanitizer available for visitors and residents. Facility staff was observed with mask on.

LPA toured residents’ rooms to be adequately lit and furnished. Bathrooms are observed with trash cans with no lid. Hand washing posting was not observed in bathroom sinks. Residents each have a private room with bathroom. LPA checked residents’ locked medications. Food supply was checked and appeared to be an adequate supply. LPA observed a 30-day PPE supplies.

A sample residents record has updated emergency contact information. Staff records were reviewed for infection control training. The exterior tour was conducted. Side gate was self-closing and self-latching.

No deficiencies issued during this inspection.

Exit interview was conducted. Licensee will submit the following requested forms/information to Fresno CCL by: 05/09/22: Lic 308, Lic 309 (if applicable), Lic 500, Lic 610E, Lic 9020, current Liability Insurance, and current Administrator Certificate. A copy of this report was provided to Administrator.

SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:
DATE: 05/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/02/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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